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United States Patent |
6,142,967
|
Couch
|
November 7, 2000
|
Heel pain relief method and brace
Abstract
The following heel brace and method to reduce heel pain by securing a strap
on the outer side of the ankle and bringing the strap under and up to a
securing means on the opposite side of the foot whereby the calcaneus or
heel bone is rotated to change the contact point of the heel and ground
surface.
Inventors:
|
Couch; Brian M. (5 Glencove Ct., Simpsonville, SC 29681)
|
Appl. No.:
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358051 |
Filed:
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July 21, 1999 |
Current U.S. Class: |
602/66 |
Intern'l Class: |
A61F 013/00 |
Field of Search: |
602/27,65,66,63,60
128/882,876
2/239,240
|
References Cited
U.S. Patent Documents
4409976 | Oct., 1983 | Pence | 602/65.
|
5554107 | Sep., 1996 | Shannahan | 602/66.
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5620413 | Apr., 1997 | Olson | 602/65.
|
5865779 | Feb., 1999 | Gleason | 602/30.
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Foreign Patent Documents |
114560 | Aug., 1984 | EP | 602/65.
|
Other References
Manual Therapy "NAGS", "SNAGS", "MWMS" etc., Third Edition, Author: Brian
R. Mulligan, 1995 p. 118-119.
|
Primary Examiner: Lee; Kim M.
Attorney, Agent or Firm: Lee, Jr.; William D., Flint; Cort
Claims
What is claimed is:
1. A heel pain relief method comprising the steps of:
a) securing one end of a non-elastic strap to the outside mid-ankle at a
position at least the height of the subtalar joint of the ankle;
b) bringing the strap angularly down and rearward under the rear base of
the heel so that the strap will form an acute angle with a support surface
when standing erect thereupon;
c) applying tension to said strap as it is brought under the heel; and
thereby,
d) repositioning the calcaneus with respect to the talus by rotating and
moving the base of the calcaneus inwardly;
e) bringing said strap upwardly under tension from the heel base and
angularly forward toward the inside mid-ankle; and,
f) securing the other end strap to the inside of the mid-ankle to retain
the tension in the strap and maintain the calcaneus in its repositioned
relationship with the talus, thereby releasing heel pain.
2. The method of claim 1 including prior to step a) the steps of:
i) providing an elastic sleeve shaped to snugly fit around a human ankle
and heel from above the ankle to the mid-arch of the foot; said sleeve
having an outside mid ankle area exterior of said sleeve for securing one
end of said strap and having an inside mid-ankle area exterior of said
sleeve adapted for attaching the other end of said strap securely thereto;
and after performing step a) of claim 1,
ii) inserting the foot with the heel needing pain relief into the sleeve so
that the sleeve fits snugly about the ankle.
3. The method of claim 2 including prior to performing step b), the steps
of:
i) attaching one Velcro fastener patch to the exterior inside mid-ankle
area of said sleeve;
ii) attaching the other Velcro fastener patch to said other end of said
strap whereby said strap may be secured when performing step f) of claim
1.
4. The method of claim 1 wherein in step e) the strap is brought over the
top of the foot and in step f) the other end of the strap is secured on
the outside of the ankle.
5. A heel pain relief brace comprising:
a) a sleeve shaped to snugly fit around a human ankle and heel from above
the ankle to the mid-arch of the foot, said sleeve comprising an elastic
material that will firmly maintain its dimensional stability when
stretched to about its elastic limit;
b) a non elastic strap affixed at one end thereof to the outside surface of
the sleeve in the outer mid-ankle area of said sleeve, said strap being
affixed so that it can readily be pulled downwardly and backwardly below
the rear portion of the heel;
c) attaching means associated with the other end of said strap area, said
securing means being adapted to receive and hold the attaching means and
form a firm grip when said strap has been pulled under the rear portion of
the heel and secured to said securing means to re-position the calcaneus
and hold the calcaneous as so repositioned.
6. The brace of claim 5 wherein the securing and attaching means of said
strap is a Velcro fastener fabric, one having the fabric with hooks and
the other with loops.
7. The brace of claim 5 wherein the attaching means is a series of eyelets
in the other end of said strap and the securing means is a buckle and
tongue for locking insertion into an eyelet to secure said other end of
the strap.
8. The brace of claim 5 wherein said sleeve of said brace is formed of
neoprene.
9. The brace of claim 5 wherein said sleeve is formed from woven elastic
fabric material.
10. The brace of claim 5 wherein the strap is formed of woven nylon.
11. The brace of claim 5 wherein the securing means is located on the
outside mid-ankle surface of the sleeve on the inner side of the ankle and
the said one end of said strap is attached below the tibia in a position
so that when the calcaneus is rotated 1 degree to 3 degrees from its
previous position said strap will hold the calcaneus as repositioned.
12. The brace of claim 5 including an outer side reinforcement member
associated with the sleeve for stabilizing the position of said strap.
13. A heel pain relief brace comprising;
a) a sleeve adapted for snugly fitting around a human ankle with
dimensional stability, said sleeve having securing means on its inner
ankle side;
b) a non elastic strap for rotating the calcaneous inwardly to reposition
and hold the calcaneous in its new position, said strap being attached to
the outer ankle side of said sleeve whereby when pulled downwardly and
backwardly under the heel and upwardly to attach to said securing means,
said sleeve will cooperate with said strap to maintain the calcaneous in
its new position.
Description
FIELD OF THE INVENTION
This invention relates to a method for relieving heel pain and to a brace
for carrying out the method.
BACKGROUND OF THE INVENTION
The occurrence of foot and heel pain is an especially uncomfortable and
often debilitating condition which significantly limits activity. It is
frequently associated with jogging, tennis, volleyball or other activities
which require repeated impact of the tissues on the bottom of the foot and
particularly in the heel region. In the anatomy of the human foot, the
plantar fascia is the connective tissue on the bottom of the foot which is
attached at the front to the metatarsal phalangeal joints, i.e., the
metatarsal or toe joints, and at the rear to the calcaneus or heel bone.
The plantar fascia acts like a pad to absorb the shock of the forces
developed during the strenuous activities mentioned and, during all
walking or running activities the plantar fascia stretches and contracts
and is subject to impact forces. Continuous stress of the plantar fascia
can cause loss of the natural elasticity or padding function of the
tissue. This resulting loss of elasticity can produce physical symptoms
that include tenderness, swelling, and pain. In some instances bone spurs
can develop causing even more pain. To relieve the pain and promote
healing, usually requires rest and removal of the cause of the condition
which, obviously, is the walking or running.
To treat the condition without surgery it has been a practice to tape a
strap to the bottom of the foot to produce an external pull on the plantar
fascia and keep the tissue compressed and immobilized, to administer
anti-inflammatory drugs to reduce swelling, and to perform stretching
exercises for the planar fascia. Often, this treatment is successful but
the tape strapping method, to be effective, requires application by
trained medical personnel and as the tape loses its adhesion re-taping is
required. Accordingly, it is one object of the present invention to
provide a method and a brace which can be adjusted readily by the patient.
One elastic brace or foot wrap for treating heel pain is described in U.S.
Pat. No. 5,554,107 to Shannahan granted Sep. 10, 1996. This foot wrap
comprising an elastic tubular body having an ankle opening, a plurality of
toe openings, an arch support, wherein the tubular body exerts a
predetermined compressive force to support the arch of the foot. The
compressive force is exerted by the wrap along the bottom of the foot from
the heel to the toes while additionally providing support for the arch of
the foot by means of the arch support. The arch support is drawn around
and over the lateral and medial sides of the foot and attached to the top
of the tubular body by means of Velcro patches. Among the drawbacks to
this foot wrap and method are that it requires enclosing a major portion
of the foot inside the foot wrap requiring multiple fittings and
adjustments to be properly installed. Accordingly, it is another object of
the present invention to provide a wrap or brace which does not need to
enclose a large portion of the foot and has a single simple adjustment
means.
Another brace is described in U.S. Pat. No. 5,620,413 to Olson granted Apr.
15, 1997 wherein a combination of an ankle brace and wrap is described
which is a compressive support sleeve adapted to fit over the foot of a
user. A non-elastic strap is secured to a pressure support sleeve and
wraps around the plantar fascia of the foot and back around the ankle
forming a figure-eight configuration. Two pressure release pads are
disposed on a compression support sleeve parallel to each other forming a
channel along the Achilles tendon of the patient to provide a
redistribution of the forces from the wrap and the Achilles tendon. While
this ankle brace adds support to the ankle and to the arch it does not
effectively correct any misalignment between the talus and calcaneus which
is often the primary source of heel pain. Accordingly, it is still another
object of the present invention to correct the alignment between the
calcaneus and the ankle joint.
In U.S. Pat. No. 5,865,779 to Gleason granted Feb. 2, 1999 an enveloping
elastic sock for treating plantar faciitis is described wherein the sock
has a heel opening and exerts compressive force along the longitudinal and
transverse axes of a patient's foot. However, the elastic sock described
in this patent requires the involvement of the toes with a brace in the
back of the heel which is unnecessarily complex and is not directly
involved with realigning the calcaneus and ankle joint.
In a prior art strapping method described by Brian Mulligan at page 118 and
119 in his book in an article entitled Manual Therapy 3.sup.rd Edition,
Planeview Service, Ltd. Wellington, New Zealand, 1995 describes a method
of taping using adhesive to alter the position of the calcaneum in
relation to the talus. This is achieved by taping the calcaneum in
external rotation. Two strips (approximately two centimeters wide) are
used. A first tape is placed obliquely around the back of the heel, and
while the calcaneum is forcibly externally rotated and then the tape is
wrapped up around the lower leg to maintain the position. The second tape
is applied over the first to make the rotation even more effective. When
the patients stand they initially have difficulty walking because of the
re-positioning but no pain is supposed to be felt. The tape is left for
forty-eight hours and the results noted. This part of the treatment for
heel pain and may have to be used for a week or two with re-taping.
Accordingly, it is still another object of the present invention to
provide a method of re-positioning the calcaneus but does not require
extensive taping and re-taping of the ankle and foot area and eliminates
the discomfort of irritations that may be caused by prolonged adhesive
tape contact with the skin.
The foregoing and other objects are achieved by the present invention
described below and shown in the attached drawings.
SUMMARY OF THE INVENTION
It has been surprisingly discovered that heel pain can be almost
immnediately alleviated by rotating the heel bone or calcaneus with
respect to the ankle joint or subtalar joint and maintaining its new
position whereby the patient can almost always immediately walk on their
re-positioned heel with substantially all of the pain alleviated. This
repositioning is achieved and maintained without the use of adhesive tape
and minimum patient discomfort is incurred.
In one aspect, the present invention is a heel pain relief method
comprising the steps of securing one end of the non-elastic strip to the
outside mid-ankle at a position at least the height of the subtalar joint
of the ankle; bringing the strap angularly down and rearward under the
rear base of the heel so that the strap would form an acute angle with a
support surface when standing erect thereupon; applying tension to said
strap as it is brought under the heel, and, thereby, re-positioning the
calcaneus with respect to the talus by rotating and moving the base of the
calcaneus inwardly; bringing the strap under tension upwardly from the
heel base and angularly forward to the inside mid-ankle; and, securing the
other end of the tape to the inside of the mid-ankle to retain the tension
in the strap and maintain the calcaneus in its re-positioned relationship
with the talus thereby relieving heel pain. The method includes providing
an elastic sleeve shaped to snugly fit around a human ankle and heel from
above the ankle to the mid-arch of the foot; said sleeve having an outside
mid-ankle area exterior of said sleeve for securing one end of the strap
and having an inside mid-ankle area exterior of the sleeve adapted for
attaching the other end of said sleeve securely thereto after the strap
has been brought angularly down and around the rear under portion of the
heel.
In another aspect, the present invention is a heel pain relief brace
comprising a sleeve shaped to snugly fit around a human ankle and heel
from above the ankle from the mid-arch of the foot, said sleeve comprising
an elastic material that will firmly maintain its dimensional stability
when stretched to about its elastic limit; a non-elastic strap affixed at
one end thereof to the outside surface of the sleeve and the outer
mid-ankle area of the sleeve, said strap being affixed so that it can
readily be pulled downwardly and backwardly below the heel; attaching
means associated with the other end of said strap when the strap has been
pulled under the rear portion of the heel; securing means on the outside
surface of the sleeve and the inner mid-ankle area, said securing means
being adapted to receive and hold the attaching means and form a firm grip
wherein the strap is pulled under the rear portion of the heel to
re-position the calcaneus. The securing and attaching means may include
Velcro fastener fabric, a buckle, or snaps.
DESCRIPTION OF THE DRAWINGS
The above described invention may be better understood by reference to the
drawings which are attached hereto and made part of this specification and
illustrate the present invention but are not intended to limit its scope.
In the drawings:
FIG. 1 is a representation in elevation of one embodiment of the invention
showing the surface from the inner side thereof;
FIG. 2 is a representation in elevation of the heel pain relief brace of
the present invention in FIG. 1 showing the surface of the outer side
thereof;
FIG. 3 is a representation in elevation showing an ankle and foot
positioned in the heel pain relief brace of FIGS. 1 and 2;
FIG. 4 is a view looking at the bottom of the foot shown in FIG. 3 with the
bones of the foot and ankle shown in shadow lines;
FIG. 5 is a view of the opposed side of FIG. 3 showing the ankle bones and
calcaneus in shadow and also showing the acute angle of the securing strap
with the horizontal support of the floor;
FIG. 6 shows the ankle and heel in elevation looking from the rear of the
heel with the heel pain relief brace in position prior to the heel
adjusting strap being rotated into position;
FIG. 7 is a view of FIG. 6 showing the adjusting strap being rotated into
position;
FIG. 8 is a view of FIG. 7 showing the adjusting strap in its secured
position; and,
FIGS. 9, 10, and 11 are the same views as FIGS. 6, 7, and 8 showing an
alternate embodiment of the invention.
DETAILED DESCRIPTION
Turning first to FIG. 1 heel pain relief brace 1 is shown from the outer
side and comprises sleeve 2, heel position adjusting strap 3, securing
means 4 located at approximately the mid-ankle position, and Velcro mating
surface 5 on the strap 3. The sleeve 2 is preferably made from an elastic
or suitable fabric such as that which is woven from synthetic yarn sold
under brand names such as Spandex or Lycra by duPont. The sleeve 2 can
also be formed from neoprene or any similar elastic or rubber-like
material which can be perforated to allow the enclosed ankle and foot
surface skin to "breathe". Such material when pulled or stretched to near
its elastic limit should be secure and dimensionally stable. The Velcro
patch 4 is the mating surface for Velcro patch 5 and the Velco surface is
made from the mating plastic hooks and loops as sold by Velcro Industries
BV of Amsterdam. Other securing means can be a buckle located at position
4 and with a tongue to be inserted in the eyelets on strap 3 so that the
strap may be buckled on. A snap fastener arrangement can also be employed.
The strap 3 is made from a dimensionally stable, non-elastic material such
as woven nylon.
Looking now at FIG. 2, which is the opposite side of brace 1 from that
which is shown in FIG. 1, strap 3 is shown secured to strap attachment
means 6. The strap attachment may be made with high strength glues which
are well known in the art, by sewing, or by rivets or buttons and
buttonhole arrangement. That attachment positions 4 and 6 for the strap 3
are in the mid-ankle region which is in the region of the medial
malleolus.
FIG. 3 shows the heel pain relief brace 1 from the same or inner side as is
shown in FIG. 1 but in FIG. 3 a human foot 7 is inserted into the sleeve 2
which fits the foot in a snug and secure manner. The ball 8 of the foot or
pad area extends beyond the sleeve as does the upper ankle or lower leg 9.
In FIG. 3 this strap 3 is in place and the angle between the strap and the
horizontal surface or floor upon which a foot normally stands is shown.
This angle is less than 900 and is preferably in the range of 30.degree.
to 60.degree. and most preferably between about 30.degree. to 45.degree..
FIG. 4 is a view of FIG. 3 from the bottom side of the foot and shows the
foot bone structure 11 in shadow line and also illustrates the toes 13.
The strap attachment 6 is shown in its preferred position across the heel
10. FIG. 5 shows the opposite side of the foot 7 from that shown in FIG. 3
and this view is from the inner side of the ankle. The inner side is the
side which is on the left of the bottom of the foot shown in FIG. 4 and
the inner side is the side on which the big toe is located. In FIG. 5 the
strap 3 is shown in position and attached at sleeve attachment 6 and the
strap 2 makes an angle .theta..sub.i. And like the angle on the opposite
side as shown in FIG. 3, the angle .theta..sub.o and .theta..sub.i should
be approximately the same.
Looking next at FIGS. 6, 7, and 8 the method of the invention will be
described. In each of these figures the lower leg, ankle, and foot are
shown from the rear and in this arrangement the foot would be the right
foot wherein the strap 3 is fastened to the sleeve at attachment 6. The
bones of the ankle are shown in shadow and specifically the calcaneus 14
and talus 16 can be seen. The vertical central line 15 is drawn with
respect to the position of the calcaneus 14. Normally there is a 3.degree.
to 4.degree. angle from the vertical known as the tibia varum angle of the
normal leg which is mildly bowed. One feature of the present invention is
that it has been discovered that by rotating the calcaneus in the
direction of the natural bow of the foot and leg and securing the
calcaneus in this position significantly and almost instantaneously
relieves leg or foot pain. Patients are surprised at the quick relief
obtained.
The method begins with pulling the strap 3 to the left or to the inside
(medially) and applying manual tension T in the direction as shown in FIG.
7. This causes the calcaneus 14 to rotate in the direction shown by the
arrows. The purpose is to reduce the magnitude of angle d.sub.1 and to
bring it to a smaller angle d.sub.2 as shown in FIG. 8 as the strap 3 is
pulled under the heel as is being done in FIG. 7. The strap is then
brought up onto the side of the foot and attached at the matching Velcro
pad 5 which is located on the outside of the sleeve 2 on its surface on
the inner side of the sleeve. Once secured with the calcaneus rotated with
respect to the talus 16 and consequently the tibia 18, realignment is
achieved which will reduce heel pain. This is due in part to the fact that
the pain producing point on the heel which transfers the contact force of
walking to the lateral border of the calcaneus has been moved to a new
point of contact with the floor or ground. The point of contact and the
calcaneus have been turned in the direction of the natural bow of the leg
and foot. The actual rotation of the calcaneus is only a few degrees, less
than 5.degree., and usually in the range of 1.degree. to 3.degree..
Once the strap 3 has been fastened to the securing patch the realignment of
the calcaneus will remain. It is important that when this strap is brought
down from its attachment point as shown in FIG. 2 it forms an acute angle
.theta..sub.i as shown in FIG. 5 so that it will be comfortably and
correctly positioned across the bottom of the heel as shown in FIG. 4.
This same angle should approximately be maintained as the strap is brought
up on the inner side of the ankle as shown in FIG. 3. When the brace 1 is
correctly installed in this manner heel pain will be significantly, if not
completely, reduced.
In FIGS. 9, 10, and 11 the addition of reinforcing member or side support
member 20 is shown. This is another embodiment of the present invention
and comprises a semi-rigid insert which conforms to the shape on the side
of the lower ankle and stiffens the area of the sleeve 2 between the
securing means 6 and the rear part of the heel to enable the strap to be
pulled tightly down around and underneath the heel and fastened to the
securing means 5. As can be appreciated, the stiffening or reinforcement
20 is positioned so that its lower edge abuts the bottom of the sleeve and
resists turning so that the tension in the strap will be maintained.
Many other embodiments, improvements, and alternates will become evident to
those skilled in the art upon having read my foregoing specification and
therefore my invention is limited only by the scope of the claims set
forth below.
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